Re: Chest Pain
Hi Summer, The absolute worst thing you can do is not take chest pain seriously. Next time you are having chest pain go directly to the ER, they don't make people with chest pain wait and they will do an EKG as part of the triage if you having chest pain while your there. If you go to the doc 2 days later and inquire about the chest pain you had, you will be blown off, every other possible cause of chest pain, like GERDS, Reflux and hiatal hernia will be suggested. You will end up with a prescription for stomach meds rather than getting a cardio work up.
Statistics on the death rate for first time heart attacks or "MI"'s for woman are appalling. This is because women don't tend to go directly to the ER and heart attacks present a little differently in women than they do in men. Women are more prone to finish thanksgiving dinner or continue with holiday festivities they have planned, rather than seeking the medical attn they need. Women are more prone to ride it out and hope it passes, this is why a much greater percentage of woman die from their first heart attack due to lack of immediate care, self diagnosis and delayed diagnosis.
If you go in 2 days later, the assumption is you didn't have a heart attack or you would have been in the ER when you were experiencing chest pain. It wouldn't shock me to hear if you went to the ER 2 days later and they didn't even do an EKG or do blood work to check the the antibodies produced from a heart attack. You may not have the classic left arm pain but you may have shoulder pain or other symptoms that don't scream heart attack.
The best way to DX a heart problem is to be in the ER while your having chest pain. If the pain isn't severe enough to make you go to the ER it's presumed you didn't have a heart attack and other reasons that cause chest pain that don't require immediate intervention like cardiac cath, heart and BP meds, nuclear or stress testing simply isn't done if the episode wasn't severe enough to make you go to the ER.
Having a turkey in the oven isn't a reason not to go to the ER if your having chest pain, unfortunately women do tend to put off a trip to the ER if the pain passes in 15 minutes and you're lucky enough to survive. When you go to the GP 2 days later and complain of chest pain, most docs aren't going to consider whatever happened a life threatening event if you can sit there 2 days later and calmly explain what you experienced. It would be like saying I think I had a stroke over the weekend but had a dinner party and couldn't let everyone down.
If the chest pain isn't severe enough to risk letting dinner guests down, docs aren't going to consider your symptoms severe enough to do the proper testing or referring to a cardiologist.
I had a heart attack on my 36th Bday, I was silly enough to think if you get to the ER in time there was something they could do to stop a heart attack or intervene somehow. Turns out, other than NitroG, there is no intervention procedure to stop a heart attack. They do treat the tremendous pain and when your heart stops they have the ability to restart your heart. Unfortunately women statistically tend to slip off into another room and ride it out hoping not to disrupt dinner plans, holiday plans etc. When they do go to the doc, the episode has passed and ER docs don't tend to take chest pain a couple of days ago the same way they do when you actually having a heart attack on the gurney and they can watch it happen. That may sound sexists, but statistics don't lie. Women simply don't seek immediate treatment the same way men do. Symptoms are usually a little different in women, so someone with chest pain that doesn't have the notorious left arm pain is more likely not to to seek immediate medical attn.
When I was in the hospital, nobody was surprised by a 36 year old having a heart attack with no family or personal history. My only history was High BP and that was always taken when I was being seen or treated for chronic pain. Even with BP meds and the best pain relief I can achieve, My BP still puts me at twice the risk of a person with normal BP. The CICU nurses also said that they see at least 1 person in their 20's have a heart attack every month. It's unusual, but not that uncommon. There is no such thing as being too young to have heart problems. Being young and thinking it couldn't be a heart atack is another reason that causes delay of treatment and a negative outcome..
Better to feel foolish and spend a few hours in the ER than to have a loved one find you in your bedroom blue and 15 minutes from an ER. You have 3 minutes from the time your heart stops until brain death begins to occur. So the absolute worst thing you can do is not inform someone you are in distress and not seek immediate treatment while it's happening.
You will have to ride it out anyway, but if you want to survive a heart attack , you want meds and cardio electric shock close at hand. Laying down for a few minutes when your have chest pain, feel clammy, sick to your stomach, or have referred pain somewhere other than the left arm leaves the spouse, children, family members or friends to find you dead 20 minutes later when someone remembers to check on you.
Due to variations in presentation of symptoms and delayed response to symptoms like waiting to go to the doc/ER, the mortality rate for first time heart attacks among woman is almost twice that of a man.
Please take all chest pain very seriously. I learned all these stats from the women that ran the cardiac rehab program I attended after having 3 stints placed in my LAD just hours after the heart attack. The LAD is the "left anterior descending artery" also known as the widow maker. Fortunately I didn't think the pain I was having this time was GERDS, reflux or a hiatal hernia because I was drenched in a cold sweat at the time. Stomach problems can easily mimic chest pain since the stomach and heart transmit signals along the same nerve pathway. So stomach problems and heart problems can be easily confused. There is no way we can determine which it is on our own. Trying to self DX chest pain is like playing Russian roulette.
Good luck, Dave
Last edited by Shoreline; 11-10-2006 at 08:24 AM.